. The Principles and practice of gynecology : for students and practitioners. terus is indicated : first,when the uterus is septic or otherwise so diseased as to render thepresence of any part of it unsafe ; second, when on account of exten-sive traumatism or suppuration vaginal drainage is required. Inaddition to the above indications there is a certain legitimate latitudeof choice, so that the bias of the operator properly may be in thedirection of complete hysterectomy. The operation demands thesame antiseptic preparation as already laid down for supravaginalhysteromyomectomy. Technique of
. The Principles and practice of gynecology : for students and practitioners. terus is indicated : first,when the uterus is septic or otherwise so diseased as to render thepresence of any part of it unsafe ; second, when on account of exten-sive traumatism or suppuration vaginal drainage is required. Inaddition to the above indications there is a certain legitimate latitudeof choice, so that the bias of the operator properly may be in thedirection of complete hysterectomy. The operation demands thesame antiseptic preparation as already laid down for supravaginalhysteromyomectomy. Technique of Complete Abdominal Hysteromyomectomy.—The ab-dominal incision ; the delivery of the tumor ; the clamping and liga-ture of the arteries ; the division of the broad ligaments ; and theclosure of the wounds, both pelvic and abdominal, are substantiallythe same as already described for supravaginal peculiarities in technique, however, should be observed asfollows: When the cervix is accessible through the vagina, the first incisions Ki<;tiRK Supravaj;iiial Hysteromyomectomy. Ordinary method of closing broad ovarian and uterine arteries have been secured by means of strong catgut ligature:^,the uterine stump has been closed by a continuous suture running from side to side, andthe wound in the broad ligaments is being whipped together by a continuous catgutsuture. The ligatures on the uterine arteries are covered in by peritoneum, those onthe ovarian ai-teries are not so covered. 1 This series of illustrations. Figures 17-t to 18-5, with text, were published by theauthor in the Journal of the American Medical Association, March 29, 1902. 373 FiGUBE 17-5.
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